Wonder Junction at Bethlehem Baptist Tabernacle

Street

Street 2

City

State/Province

Postal Code

Parent/Guardian First Name

Parent/Guardian Last Name

Primary Phone

Alternate Phone

Emergency Contact

Relationship to Student

Phone Number

Person(s) allowed to pick up child(ren)

First Name

Last Name

Gender

Male

Female

Birth Date

Age Group

4-6 years old

7-9 years old

10-12 years old

Food Allergies

Details

Medical Concerns

Details

I have more students to register

This site is protected by reCAPTCHA, and the Google Privacy Policy and Terms of Service apply.

Cancel

Register for VBS